Adverse Events During Perampanel Adjunctive Therapy in Intractable Epilepsy.
10.3988/jcn.2018.14.3.296
- Author:
Song Ee YOUN
1
;
Se Hee KIM
;
Ara KO
;
Sun Ho LEE
;
Young Mock LEE
;
Hoon Chul KANG
;
Joon Soo LEE
;
Heung Dong KIM
Author Information
1. Divison of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. hdkimmd@yuhs.ac
- Publication Type:Original Article
- Keywords:
perampanel;
drug-resistant epilepsy;
antiepileptic drug;
α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid
- MeSH:
Appetite;
Appointments and Schedules;
Dizziness;
Drug Resistant Epilepsy*;
Epilepsy;
Female;
Gait;
Humans;
Seizures;
Sex Characteristics
- From:Journal of Clinical Neurology
2018;14(3):296-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Perampanel is the first α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)-receptor antagonist developed to treat epilepsy. The effects of either rapid or slow dose titration on adverse events remain to be elucidated. METHODS: Eighty-five patients received perampanel between March 2016 and August 2016. Patients were divided into two groups according to their dosing schedule: rapid dose titration (2-mg increments at intervals of 1 to 2 weeks) and slow dose titration (2-mg increments at intervals of at least 3 weeks). Seizure frequency and adverse events were analyzed over 3 months. RESULTS: Adverse events were reported by 47 (58%) of the 81 patients analyzed, with 12 (15%) patients discontinuing perampanel due to adverse events. Common adverse events included dizziness (n=30, 37%), aggressive mood and behavior (n=19, 24%), gait disturbance (n=16, 20%), and sleep problems (n=10, 12.4%). The overall adverse events were similar in the slow-titration group (38 of 61 patients) and the rapid-titration group (8 of 20 patients, p=0.081). However, none of the 20 patients in the slow-titration group experienced gait disturbance, compared with 16 of the 61 patients in the rapid-titration group (p=0.009), while appetite change was experienced by 4 patients in the slow-titration group but only 1 in the rapid-titration group (p=0.003). No relationship was noted between adverse events and the maximum dose of perampanel (p=0.116). Sex differences were observed, with the response to perampanel being better and the rate of adverse events being higher in females (p=0.015 and p=0.046, respectively). CONCLUSIONS: Slow titration of perampanel may reduce perampanel-related adverse events.
